December 2000 Bulletin

Tips on how to "rate" with your patients

Elizabeth Stringer offers the following suggestions based on her experiences with orthopaedic surgeons and other physicians who receive high marks on her patient office performance surveys.

• Make the office visit, and the decisions about treatment, a "we" experience; convey the attitude that "we’re in this together." Tell the patient, for instance, "These are our options…If you were my father, this is what I would recommend."
• Make the patient an individual. If you’re not a natural at remembering the details of your patients’ lives, use sticky notes. For instance…A patient mentions in her first visit that she’s taking her son to school soon. Jot that down on a sticky note. Next time you see her, ask "So, how’s your son doing at Notre Dame?" Patients don’t expect it, and it blows them away. And it’s such a simple method.
• Keep your reception room waiting time below 22 minutes. The average patient will wait up to 22 minutes before looking at his/her watch, wondering if they’ve been forgotten. With an average wait time of 45 minutes or so, there’s very little you can do that will increase satisfaction with the doctor–they’re pretty "ticked" by then.
• Hand patients a 3" by 5" card to complete in the reception room where it’s quiet and they’re not face-to-face with the doctor. Ask them, "What is your main concern, or one key question you’d like answered during this visit?"

It’s important to understand that the patients’ anxiety level is high, and they often won’t hear a thing the doctor says until that key question is answered. For instance, if a woman came in with a lump on her leg, most doctors will think she’s concerned about cancer. But if she needs a total hip replacement, the doctor may not know that her Aunt Ellen died when she had hers done 25 years ago. So that patient’s key question will be ‘What are my risks of dying?’ To a single mother of three with carpal tunnel, the main concern may be "I have three kids I support as a hair dresser–when will I be back at work?"

The cards give the doctor the opportunity to say "I see you have an aunt that died from this procedure, let’s go into the risks of the operation in a little more depth." Or, "I see that you’re the sole supporter of your three children–let me assure you that I will do everything I can to get you back to work."

• Hire people-oriented staff. Highly rated physicians also have nurses that rate high, and they usually have a real key "right-hand" person who is as well-liked as the doctor. For those doctors who have excellent technical skills but are somewhat lacking in social skills, it’s imperative they surround themselves with very warm, people-oriented staff members.
• Be a WOW doctor–doctors whose patients think they "walk on water." These docs stand up for their patients, and sometimes that means bucking the system. Whether it’s telling the patient you’ll do whatever you have to do to get the insurance company to pay for a procedure, or talking to a creditor because a patient has been in the hospital for so long. Patients of WOW docs can’t believe anyone would go to another doctor.